المؤلفون: Géraldine Bart, Benoit Le Goff, Laurie Charret, Grégoire Cormier, David Boutoille, Emmanuelle Dernis, Christelle Darrieutort-Laffite, Emmanuel Hoppe

المصدر: Journal of Antimicrobial Chemotherapy. 76:3029-3032

مصطلحات موضوعية: Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Bursitis, medicine.drug_class, Olecranon, 030106 microbiology, Antibiotics, medicine.disease_cause, Septic bursitis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Antibiotic therapy, Elbow Joint, medicine, Humans, Pharmacology (medical), Olecranon Process, Pharmacology, 030222 orthopedics, Streptococcus, business.industry, Bacterial Infections, Middle Aged, medicine.disease, Comorbidity, Anti-Bacterial Agents, Infectious Diseases, medicine.anatomical_structure, Cellulitis, Female, business

الوصف: Background No current guidelines are available for managing septic bursitis (SB). Objectives To describe the clinical characteristics and management of olecranon and prepatellar SB in five French tertiary care centres. Methods This is a retrospective observational multicentre study. SB was diagnosed on the basis of positive cultures of bursal aspirate. In the absence of positive bursal fluid, the diagnosis came from typical clinical presentation, exclusion of other causes of bursitis and favourable response to antibiotic therapy. Results We included 272 patients (median age of 53 years, 85.3% male and 22.8% with at least one comorbidity). A microorganism was identified in 184 patients (67.6%), from bursal fluids in all but 4. We identified staphylococci in 135 samples (73.4%), streptococci in 35 (19%) and 10 (5.5%) were polymicrobial, while 43/223 bursal samples remained sterile (19.3%). Forty-nine patients (18%) were managed without bursal fluid analysis. Antibiotic treatment was initially administered IV in 41% and this route was preferred in case of fever (P = 0.003) or extensive cellulitis (P = 0.002). Seventy-one (26%) patients were treated surgically. A low failure rate was observed (n = 16/272, 5.9%) and failures were more frequent when the antibiotic therapy lasted Conclusions Despite variable treatments, SB resolved in the majority of cases even when the treatment was exclusively medical. The success rate was equivalent in the non-surgical and the surgical management groups. However, a treatment duration of

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dafaeae5cf13b4a9e6db087760bf84c9Test
https://doi.org/10.1093/jac/dkab265Test

المؤلفون: Claire Bernier, Hélène Aubert, Jean-Marie Berthelot, Antoine Néel, Christian Agard, Sébastien Barbarot, Benoit Le Goff, Mohamed Hamidou, Agathe Masseau, Françoise Kraeber-Bodéré, Christelle Darrieutort-Laffite, Catherine Ansquer

المصدر: Arthritis Research & Therapy, Vol 22, Iss 1, Pp 1-10 (2020)
Arthritis Research & Therapy

مصطلحات موضوعية: Male, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Interleukin 1 receptor antagonist, Single Center, Cohort Studies, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Schnitzler syndrome, Musculoskeletal Pain, Internal medicine, medicine, Humans, Bone pain, Retrospective Studies, business.industry, Waldenstrom macroglobulinemia, Retrospective cohort study, Bone scan, medicine.disease, Rash, Rheumatology, Bone lesions, Cohort, Female, medicine.symptom, lcsh:RC925-935, business, 030215 immunology, Research Article, Follow-Up Studies

الوصف: Objective To report on the characteristics and long-term course of rheumatic manifestations in Schnitzler syndrome (SchS). Methods A retrospective cohort study of patients with SchS followed between 2000 and 2020. Inclusion criteria included a diagnosis of SchS (Strasbourg criteria). All available bone scans were reviewed and scored according to the intensity and number of pathological sites. The scintigraphic score was compared with the clinical activity score, CRP level, and treatments. Results Twenty-five patients were included. Median age at diagnosis was 68 years. Eighty patients (72%) had SchS-related rheumatic pain. Most patients had a long-standing isolated rash before constitutional and/or rheumatic symptoms appeared. The monoclonal component level was usually very low (IgMκ in 22/25). Rheumatic pain predominated around the knees. Bone scans revealed abnormal tracer uptake in 15/18 (85%). The scintigraphic score correlated with clinical activity (r = 0.4, p r = 0.47, p p Conclusions Rheumatic manifestations are very prevalent in SchS. However, bone pain can be misleading and contribute to misdiagnosis. Bone scan abnormalities are very prevalent and correlate with disease activity and treatments. IL1-Ra has a dramatic and durable efficacy but may not be required in every patient early on.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::52bd4540be4dcd843b01445f9f1276c5Test
http://link.springer.com/article/10.1186/s13075-020-02318-5Test

المؤلفون: Stéphane Varin, Grégoire Cormier, Lucie Planche, Benoit Le Goff, Guillaume Coiffier, Jean-David Albert, Christelle Darrieutort-Laffite, Yves Maugars

المصدر: Annals of the Rheumatic Diseases. 78:837-843

مصطلحات موضوعية: Adult, Male, Visual analogue scale, medicine.medical_treatment, Immunology, Equivalence Trials as Topic, Punctures, Methylprednisolone, General Biochemistry, Genetics and Molecular Biology, Injections, Intra-Articular, Rotator Cuff, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Rheumatology, Tendinitis, Shoulder Pain, Humans, Immunology and Allergy, Medicine, Therapeutic Irrigation, Glucocorticoids, Saline, Ultrasonography, Interventional, Pain Measurement, 030203 arthritis & rheumatology, Pain, Postoperative, 030222 orthopedics, Dry needling, business.industry, Calcinosis, Calcific tendinitis, Middle Aged, medicine.disease, Acute Pain, Treatment Outcome, Anesthesia, Tendinopathy, Female, Saline Solution, Subacromial bursa, business, Follow-Up Studies, medicine.drug, Calcification

الوصف: ObjectiveSteroid injections are common after an ultrasound-guided puncture and lavage (UGPL) of calcific tendonitis of the rotator cuff. However, steroids may prevent calcification resorption and negatively affect tendon healing. Our study was designed to determine whether saline solution was non-inferior to steroids in the prevention of acute pain reactions in the week following UGPL.MethodsThis was a randomised, double-blinded, controlled non-inferiority trial with 12-month follow-up. We included 132 patients (66 in each group) with symptomatic calcification measuring more than 5 mm. Patients received 1 mL of saline or steroid (methylprednisolone 40 mg) in the subacromial bursa at the end of UGPL. Primary outcome was the maximal pain during the week following the procedure with a prespecified non-inferiority margin of 10 mm (0–100 visual analogue scale). Secondary outcomes included pain at rest and during activity, function (disabilities of the arm, shoulder and hand score) and radiological evolution of the calcification over the 12-month follow-up.ResultsThe estimated mean difference in the first week’s maximal pain between these two groups was 11.76 (95% CI 3.78 to 19.75). Steroids significantly improved VAS pain at rest and during activities, as well as function at 7 days and 6 weeks. They did not change the rate of calcification resorption, which occurred in 83% and 74% of patients at 12 months in the saline and steroid groups.ConclusionNon-inferiority of saline when compared with steroids could not be established. However, steroid injection improved pain in the 6 weeks following the procedure, and function in the 3 months after, with no significant effect on calcification resorption.Trial registration numberNTC02403856.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dcece3babe2a404951bc62970e939b9fTest
https://doi.org/10.1136/annrheumdis-2018-214971Test

المؤلفون: Philippe Montigny, Grégoire Cormier, Benoit Le Goff, Céline Cozic, Gilles Tanguy, Christelle Volteau, Yves Maugars, Stéphane Varin, Joëlle Glémarec, Christelle Darrieutort Laffite

المصدر: Joint Bone Spine. 85:359-363

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Lidocaine, Visual analogue scale, medicine.drug_class, medicine.medical_treatment, Injections, Intralesional, Cortivazol, Placebo, Risk Assessment, Severity of Illness Index, Statistics, Nonparametric, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Rheumatology, Reference Values, 030202 anesthesiology, medicine, Humans, Prospective Studies, Anesthetics, Local, Glucocorticoids, Saline, Aged, Pain Measurement, Lumbar Vertebrae, Local anesthetic, business.industry, Lumbosacral Region, Middle Aged, Prognosis, Low back pain, Surgery, Treatment Outcome, Anesthesia, Drug Therapy, Combination, Female, medicine.symptom, Tomography, X-Ray Computed, business, Low Back Pain, 030217 neurology & neurosurgery, Lumbosacral joint, medicine.drug

الوصف: Objective The primary objective of this study was to compare the efficacy of local injection of a local anesthetic with a glucocorticoid versus a local anesthetic with saline to treat low back pain due to lumbosacral transitional vertebras (LSTV) with a pseudoarticulation. Methods A randomized placebo-controlled double-blind study was conducted in patients with unilateral low back pain ascribed clinically to LSTV. Patients were randomized to lidocaine plus saline (LS group) or lidocaine plus cortivazol (LC group) injected locally under computed tomography guidance. The primary outcome measure was the 24-hour mean visual analog scale (VAS) score for low back pain 4 weeks after the injection. Results Of 16 randomized patients, 15 were included in the analysis, 8 in the LS group and 7 in the LC group. The mean VAS pain score at week 4 was not significantly different between the two groups. In the two groups pooled, the mean VAS pain score decreased significantly from baseline to week 4, from 5.52 ± 0.99 to 3.86 ± 2.55 (P ≤ 0.05). The difference remained significant at week 12. Significant improvements occurred in the EIFEL disability index and items of the Dallas Pain Questionnaire. No adverse events were recorded. Conclusion In patients with chronic low back pain consistent with a symptomatic LSTV type II or IV in the Castellvi classification, a local injection of lidocaine with or without cortivazol may provide sustained improvements in pain and function. The underlying mechanism is unclear.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a9bfad3bd3d962e0479cdcb9f6bd8f59Test
https://doi.org/10.1016/j.jbspin.2017.05.003Test

المؤلفون: Benoit Le Goff, Lucie Planche, Christelle Darrieutort-Laffite, Géraldine Bart, Yves Maugars, Joëlle Glémarec

المصدر: Joint Bone Spine. 82:356-361

مصطلحات موضوعية: Anesthesia, Epidural, Male, medicine.medical_specialty, Hydrocortisone, Visual analogue scale, medicine.medical_treatment, Anti-Inflammatory Agents, Injections, Epidural, Spinal Puncture, Palpation, law.invention, Sciatica, Lumbar, Rheumatology, Randomized controlled trial, law, medicine, Clinical endpoint, Humans, Single-Blind Method, Prospective Studies, Pain Measurement, Ultrasonography, Lumbar Vertebrae, medicine.diagnostic_test, Epidural steroid injection, business.industry, Lumbosacral Region, Middle Aged, Epidural space, Surgery, Treatment Outcome, medicine.anatomical_structure, Anesthesia, Feasibility Studies, Female, medicine.symptom, business, Low Back Pain

الوصف: Ultrasound (US) is widely used in rheumatology to study and guide injection of peripheral joints. It can also provide useful information about the anatomy of the lumbar spine. Studies have shown that US examination of the spine was a useful tool to help perform epidural anaesthesia. The purpose of the study was to determine if the selection of the optimum puncture level by US may facilitate epidural steroid injection in case of presumed difficult puncture (BMI30 kg/m(2), age60 years or lumbar scoliosis).We performed a prospective randomized controlled study. Eighty patients were randomized in two groups: US group (n=40) which underwent a pre-procedure spinal US to determine the optimal lumbar level for injection or control group (n=40) for which the level of injection was determined by palpation. Primary endpoint was the pain during the procedure assessed using the Visual Analogue Scale (VAS).We found a positive correlation between depth of the epidural space and BMI (P0.001) and a negative correlation between size of the interspinous spaces and age (P0.01). Visibility of the epidural space was not altered by obesity or age. We observed a trend toward a reduction in pain intensity during the procedure in the US group compared to the control group with a mean difference at -0.94 [-1.90; 0.02] but the difference was not significant (P=0.054).US of the lumbar spine was feasible in patients with lumbar conditions even in obese and old ones and allowed the visualization of the epidural space. However, pre-procedure US examination did not reduce pain during the procedure.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::19e267d8a378100ff867b09137e81d59Test
https://doi.org/10.1016/j.jbspin.2015.02.001Test

المؤلفون: Christelle Darrieutort-Laffite, Catherine Ansquer, Jean-Marie Berthelot, Françoise Bodere, Benoit Le Goff, Yves Maugars

المصدر: Joint bone spine. 82(6)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Arthritis, Gastroenterology, Rheumatology, Predictive Value of Tests, Internal medicine, Spondylarthritis, medicine, Humans, Oligoarthritis, medicine.diagnostic_test, business.industry, Tumor Necrosis Factor-alpha, Sacroiliitis, Magnetic resonance imaging, Middle Aged, medicine.disease, Confidence interval, Bone scintigraphy, Positron emission tomography, Predictive value of tests, Positron-Emission Tomography, Sodium Fluoride, Female, Radiology, Radiopharmaceuticals, business

الوصف: Objectives To determine whether 18F-NaF positron-emission tomography (PET) contributes to the diagnosis of spondyloarthritis and whether observed uptakes predict the response to TNFα antagonist therapy. Methods We studied patients who had suspected spondyloarthritis but did not meet ASAS criteria and who were referred for an assessment of eligibility for TNFα antagonist therapy. 18F-NaF PET was offered instead of bone scintigraphy. TNFα antagonist therapy was given if the clinician's level of confidence in the diagnosis of spondyloarthritis based on 18F-NaF PET findings was ≥ 50/100. Results Thirty-one patients accepted to undergo 18F-NaF PET. Their mean age was 39.9 ± 11.7 years; 22% were HLA-B27-positive and none had evidence of sacroiliitis by magnetic resonance imaging. Of the 31 patients, 30 had abnormal 18F-NaF PET findings. However, of the 312 high-uptake foci, only 123 (39.4%) matched sites of pain. TNFα antagonist therapy was given to 16 patients. The treated group and untreated group (n = 15) were not significantly different for the mean number of high-uptake foci per patient (11.7 ± 8.1 vs. 8.3 ± 5.1, respectively) or for the proportion of patients with high uptake by the sacroiliac joints (13/16 [81%] vs. 8/15 [53%], respectively). In the treated group, 5 patients met ASAS response criteria after 3 months. These 5 patients were among the 9 treated patients who met Amor's modified criteria (arthritis instead of asymmetrical oligoarthritis). In the 5 responders, the 18F-NaF uptake scores were nonsignificantly lower than in the 11 nonresponders (9.0 ± 8.5 vs. 13.0 ± 6.4, respectively). In the patients for whom the 18F-NaF PET findings increased the level of confidence in the diagnosis of spondyloarthritis, this effect was short-lived. Discussion The positive predictive value of 18F-NaF PET for diagnosing spondyloarthritis or predicting a response to TNFα antagonist therapy seems very low. This finding is probably ascribable to poor specificity.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cf47f82fb7d205248180fc44ca7c185dTest
https://pubmed.ncbi.nlm.nih.gov/26431930Test